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Pancreatic Cancer

A cancerous tumour of the pancreas that may cause no symptoms in its early stages

More common over the age of 60

Slightly more common in females

Rarely, runs in families

Smoking, a high-fat diet, and drinking alcohol to excess are risk factors

Pancreatic cancer is a relatively rare disorder; it is diagnosed in about 7,000 people every year in the UK. The disease mainly affects people over 60 and is slightly more common in women than in men. Pancreatic cancer is almost always fatal and is one of the 10 most common causes of death from cancer in the UK.

People with pancreatic cancer usually have few symptoms until the disorder reaches an advanced stage and often not until it has spread to other parts of the body, typically to the lymph nodes in the abdomen and the liver.

Little is known about the causes of pancreatic cancer, but it has been linked with diet, in particular with fatty foods and high alcohol consumption. In a few cases, the cancer runs in a family, which indicates that a genetic factor may be involved in such cases. The risk of the disease is greater in people who smoke and in those with chronic pancreatitis.

What are the symptoms?

Symptoms often develop gradually over a few months and may include:

Pain in the upper abdomen that radiates to the back.

Loss of weight.

Reduced appetite.

Many pancreatic tumours cause obstruction of the bile ducts, through which the digestive liquid bile leaves the liver. Such blockage leads to jaundice, in which the skin and whites of the eyes turn yellow. Jaundice may be accompanied by itching, dark-coloured urine, and paler than normal faeces.

How is it diagnosed?

Imaging techniques, such as ultrasound scanning, CT scanning, or MRI, are normally used to diagnose pancreatic cancer. In addition, specialized imaging procedures such as ERCP and ultrasound scanning through an endoscope may be used to look for abnormalities in the bile and pancreatic ducts. To confirm the diagnosis, a sample of pancreatic tissue may be taken for microscopic examination.

What is the treatment?

Surgery to remove part or all of the pancreas offers the only chance of cure. However, the cancer has usually spread by the time it is diagnosed. In such cases, the aim is to relieve symptoms and slow the progression of the disease. For example, if the bile duct is obstructed by a tumour, a tube or coil known as a stent may be inserted to keep the duct open. This procedure is usually carried out during ERCP and helps to reduce jaundice. Treatment such as chemotherapy and radiotherapy may be used to slow the progress of the disease.

Pain can often be relieved with painkillers. If the pain is severe, it may be treated by a nerve block, a procedure using an injection of a chemical to inactivate the nerves supplying the pancreas.

What is the prognosis?

In many cases, pancreatic cancer is not diagnosed until it is advanced, at which time the outlook is poor. Fewer than 1 in 20 people survive more than 5 years. Even with surgery, only 1 in 10 people survive more than 5 years. Most people survive for less than a year.